Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Review of Programs for Improving Patient's Access to Medicines

의약품 접근성 향상을 위한 방안 고찰

  • Kim, EuGene (Graduate School of Public Health, Seoul National University) ;
  • Kim, Younhee (Institute of Health and Environment, School of Public Health, Seoul National University)
  • 김유진 (서울대학교 보건대학원) ;
  • 김윤희 (서울대학교 보건환경연구소)
  • Received : 2017.09.15
  • Accepted : 2017.12.06
  • Published : 2018.03.02
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Abstract

Objective: This study presented the analysis period, the complexity of combined therapy and comparator choice as the key limitations in the economic evaluation of new drugs, and discussed programs for coping with these limitations. Methods: This study evaluated the post-evaluation, risk-sharing agreement, extra funding program, and flexible incremental cost-effectiveness ratio (ICER) threshold as actions or programs that would increase accessibility to costly new drugs. The study also presented the cases of other countries. The application of the post-evaluation was considered to deal with high uncertainty regarding new drugs. Results: The risk-sharing agreement was introduced in European countries as well as South Korea and has been responsible for the shift from using the financial schemes to outcome-based schemes. The drug funding program has had troubled in securing stable extra funds. The application of higher ICER in the economic evaluation of expensive and innovative oncology drugs was criticized because of the inequity between oncology patients and patients with other diseases. Conclusion: Therefore, introducing and applying actions that would increase the accessibility to costly new drugs in South Korea have been deemed necessary after careful reviews and discussions with various stakeholders (insurer, policy makers, pharmaceutical companies and patients).

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References

  1. Ministry of Health and Welfare (MoH) & Korea Institute for Health and Social Affairs (KIHASA). OECD Health Data 2015. 2015 Available from http://www.mohw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=337336&page=1. Accessed June 10, 2017.
  2. Ministry of Health and Welfare (MoH). 2015 Statistical Yearbook of Health and Welfare. 2015. Available from http://www.mohw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=337672&page=1. Accessed June 17, 2017.
  3. Drummond MF, Sculpher MJ, Claxton K, et al. Methods for the economic evaluation of health care programmes, 4th ed. London: Oxford University Press, 2015;12-3.
  4. Ha DM. Analysis of the current performance of new drugs reimbursement and perception on policy after introducing positive list system in Korea. PhD. Thesis for Sung Kyun Kwan University. 2010.
  5. International Society for Pharmacoeconomics and Outcomes Research (ISPOR). ISPOR Global Health Care System Road Map. Available from https://www.ispor.org/HTARoadMaps/. Accessed July 3, 2017.
  6. Heo DS. Personalized cancer medicine: present status and future perspectives. J Korean Med Assoc 2015;58(11):1021-6. https://doi.org/10.5124/jkma.2015.58.11.1021
  7. Cho BC. Paradigm change of lung cancer chemotherapy. Yonsei Cancer Center Press conference, Seoul, South Korea, Feb 25, 2016. Available from http://www.google.co.kr/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&ved=0ahUKEwiw7bqJ6qzZAhWHTrwKHROfC8oQFgg7MAQ&url=http%3A%2F%2Fmdon.co.kr%2Fnews%2Fdownload.html%3Fno%3D7897%26atno%3D18329&usg=AOvVaw0IEL ZqzgGN9C8vq7D24dj1. Accessed May 8, 2017.
  8. Health Insurance Review & Assessment Service (HIRA). Economic evaluation on pharmaceuticals guideline. Dec 2011. Available from http://www.hira.or.kr/bbsDummy.do?brdBltNo=2058&brdScnBltNo=4&pgmid=HIRAA030016000000. Accessed June 10, 2017.
  9. Davis S. How do we evaluate technologies which are not cost-effective at a zero price? ISPOR 18th Annual European Congress, Milan, Italy, Nov 20, 2015. Available from https://webcache.googleusercontent. com/search?q=cache:xmWxiMwXCXUJ:https://www.ispor.org/Event/GetReleasedPresentation/552+&cd=1&hl=ko&ct=clnk&gl=kr. Accessed May 8, 2017.
  10. Kwon HY, Yang BM, Kim S, et al. Strengthening the publicity of pharmaceuticals production and supply. National Health Insurance Service Research Report. 2013. Available from http://lib.nhis.or.kr/search/detail/CATXBZ000000016911. Accessed September 23, 2017.
  11. Yang BM. Trying to understand World Health Organization's costeffectiveness threshold. J Health Tech Assess 2015;3(2):69-74.
  12. Raffery J. Multiple sclerosis risk sharing scheme: a costly failure. BMJ 2010;(340):c1672.
  13. Kim Y. Towards universal coverage: an evaluation of the benefit enhancement plan for four major conditions in Korean National Health Insurance. J Korean Med Assoc 2014;57(3):198-203. https://doi.org/10.5124/jkma.2014.57.3.198
  14. Park SV. Risk-sharing agreement on the pricing and reimbursement of new drugs. Korean J Health Econ & Policy 2010;16(2):125-53.
  15. Lee YS, Bae SJ, Lee BR, et al. Review of risk sharing arrangements in some developed countries: Focusing on type of contracts and management system. J Health Tech Assess 2017;5(1):13-21.
  16. Carlson JJ, Sullivan SD, Neumann PJ. A taxonomy and examination of performance-based reimbursement scheme between healthcare payers and manufacturers. Health Policy 2010;96(3):179-90. https://doi.org/10.1016/j.healthpol.2010.02.005
  17. Shon HS, Shin HT. Overview of risk-sharing schemes: Focusing on anticancer drugs. Korean J Clin Pharm 2013;23(2):89-96.
  18. Ministry of Health and Welfare (MoH). Ministry of Health and Welfare Annual Report 2015. 2016. Available from http://www.korea.kr/archive/expDocView.do?docId=37257. Accessed June 10, 2017.
  19. van de Voore K, Curto A, Freemantle N, et al. Market-access agreements for anti-cancer drugs. JRSM open, 2015;108(5):166-70. https://doi.org/10.1177/0141076814559626
  20. UK National Institute for Health and Care Excellence (NICE). List of technologies with approved Patient Access Schemes. Available from https://www.nice.org.uk/about/what-we-do/patient-access-schemesliaison-unit/list-of-technologies-with-approved-patient-accessschemes. Accessed August 25, 2017.
  21. UK National Institute for Health and Care Excellence (NICE) Homepage. Available from https://www.nice.org.uk. Accessed May 8, 2016.
  22. NHS England. Cancer Drug Fund (CDF) Homepage. Available from https://www.england.nhs.uk/tag/cancer-drug-fund/. Accessed May 12, 2016.
  23. Mihajlovic J, Dolk C, Tolley K, et al. Reimbursement of targeted cancer therapies within three different European health care systems. ISPOR 17th European Annual Congress, Amsterdam, The Netherlands, Nov 10, 2014. Available from https://www.ispor.org/research_pdfs/48/pdffiles/PCN250.pdf+&cd=2&hl=ko&ct=clnk&gl= kr. Accessed June 10, 2017.
  24. Italy the Italian Medicines Agency (AIFA). Negotiation list. Available from http://www.aslromah.it/informazione/farmacovigilanza/pdf/Lista_aggiornata_nuovi_Registri_14.04.2015.pdf. Accessed September 3, 2016.
  25. Cancer Care Ontario. New drug funding program (NDFP) Homepage. Available from https://www.cancercare.on.ca/toolbox/drugs/ndfp/.Accessed June 1, 2016.
  26. Australian the pharmaceutical benefits scheme (PBS). Pharmaceutical benefits advisory committee (PBAC) outcomes. Available from http://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/pbacoutcomes. Accessed September 1, 2016.
  27. Graduate School of Pharmaceutical Management Chung-Ang University. An innovative approach for evaluating the value of new medicines. International conference. Seoul, Korea, Dec 7th, 2015. Available from http://pharmind.cau.ac.kr/20150401/sub05/sub0502_view.php?bbsIdx=16. Accessed June 10, 2017.
  28. Park SV, Park EJ. Future directions for pharmaceutical policy in the new era of high cost medicines. Korea Institute for Health and Social Affairs. 2011. Available from http://repository.kihasa.re.kr/handle/201002/7683. Accessed September 1, 2017.
  29. Kim SO, Lee JH. Establish roadmap for systematic management of health insurance drug costs. National Health Insurance Service. 2012. Available from http://kiss.kstudy.com/public/public3-article.asp?key=60000722. Accessed June 10, 2017.
  30. Kim DS, Kim SJ, Jung SY, et al. Improvement of accessibility of 4 major severity diseases - focusing on funding for rare diseases and anticancer drugs-. Health Insurance Review & Assessment Service. 2016. Available from https://www.hira.or.kr/rc/icenter/study/getReportList.do?pgmid=HIRAA030095000000. Accessed June 10, 2017.
  31. Park SV. Problems of reimbursement drug pricing system & improvement Plan. Korea Institute for Health and Social Affairs Issue & Focus;No 222, 2014. Available from https://www.kihasa.re.kr/web/publication/periodical/issue_view.do?pageIndex=5&keField=myear&searchStat=2014&menuId=50&key=&tid=38&bid=21&search-Form=Y&aid=296&ano=400. Accessed June 10, 2017.

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